Development of the laparoscope and its related surgical techniques have made it possible to conduct surgery which is relatively non-invasive, without the necessity of large incisions, thus reducing trauma and the risk of infection to the patient. Laparoscopic surgery involves the use of several small incisions in the body. Through one such incision, the surgeon introduces the laparoscope, allowing the physician to insert a fiberoptic bundle that permits the surgeon to view the interior of the body. Microsurgical tools may also be inserted through the scope without impeding the physician's vision, permitting simultaneous viewing of the surgical area on a television monitor and manipulation of microsurgical tools at the surgical site. Particularly, lasers have been adapted for use with a laparoscope to conduct surgery. Often, irrigation of the surgical area is desirable. The by-products and residue resulting from laser surgery include smoke vapors generated by the laser beam cutting the tissue as well as small pieces of tissue to be removed from the area of surgery. These by-products as well as irrigation liquids must often be removed from the patient to permit a continued unobstructed view of the surgical area. Often is it necessary to apply a vacuum to the surgical area in order to evacuate the by-products and residue of microsurgical procedures or laser surgery. A key limitation of laparoscopic surgery is the necessity of keeping the number and size of instruments introduced through the scope to a minimum.
U.S. Pat. No. 4,668,215 discloses an irrigator-evacuator control for surgical procedures which allows the selective irrigation of the area of surgery and removal of surgical residue using a remote vacuum source. It discloses a device which permits both irrigation and vacuum evacuation through a single line passed through a laparoscope or similar device to the patient. Such device eliminated the need for several individual tubes for irrigation and evacuation, reducing the size of the instruments introduced through the laparoscope. It has been found that operation of the device, wherein the device was alternatively utilized for irrigation and evacuation, may produce refluxing of by-products, residue, and irrigation solution in the patient tube if all such matter is not fully evacuated from the patient tube. Secondly, it has been found that the irrigation liquid may be drawn into the vacuum line by the force of the suction.
The present invention provides a device which permits both irrigation and vacuum evacuation of a surgical site through patient tubes passed through a laparoscope or similar device. The present invention provides a device that substantially increases the space available in the laparoscope housing for the passage of other instruments while preventing the refluxing of by-products, residue and irrigation solution through the patient tube. Finally, the present invention provides more precise control over the flow of irrigation liquid to the patient and prevents the suction of irrigation solution into the vacuum line.